Emergency service will decline without more paramedics, city council told

The quality of emergency ambulance service in Lexington will take a "worrisome" decline if Lexington continues to scrimp on paramedic staffing and training, Dr. Steven Stack told an Urban County Council committee Tuesday.

Stack, a member of the city's Emergency Medical Advisory Board, said a shortage of paramedics means the city faces "a potentially very worrisome situation where we could run the risk of having inadequate work force for our needs."

Stack made a case to the council's Public Safety and Public Works Committee for including money in next year's budget to re-establish annual paramedic training classes and to operate a 10th ambulance.

The city held training classes for paramedics each year from 1977 to 2008, but it hasn't conducted one since then. The cost to train a class of paramedics, which takes about one year, is about $400,000, said assistant fire chief Michael Gribbin.

"We like to train at least 20 paramedics a year" to maintain the city's force of 200-plus paramedics Gribbin said after the meeting.

"I know you have a lot of difficult budget issues to address," Stark told the committee, but "we really need to find a way to train a new class of paramedics, as soon as possible."

However, the request comes in the face of chronic budget overruns by the fire department due to large amounts of overtime, a key reason Mayor Jim Gray asked for Fire Chief Robert Hendricks' resignation last week.

Gribbin said it is possible to hire firefighters who have been trained as paramedics by outside agencies, but that creates another problem: lack of diversity.

"The paramedic-EMT workforce throughout Kentucky is not very diverse," he said.

The latest class of 25 firefighter recruits, who graduated in February, were all pre-trained as EMTs, and about a dozen were pre-trained as paramedics, Gribbin said. They were all white males.

In addition to more paramedics, the city needs to add another ambulance to keep up with an increasing number of calls, Stack said.

The city's nine ambulances average about 3,800 runs a year. The four busiest units make more than 4,000 runs, and all nine make at least 3,270 runs.

"Historically, the community has felt when we exceed about 3,000 runs per ambulance, per year, it's time to add another ambulance in service to the community," Stack said.

The city last added an ambulance to its fleet in 2004, but the number of ambulance runs has increased from 26,679 in 2006 to 30,386 in 2010.

As a result, it's taking longer for ambulances to reach the scene of an emergency.

The city's goal is to reach an emergency within eight minutes of being called at least 90 percent of the time. The city last reached that goal in 2007.

Last year, firefighters reached emergencies within eight minutes of a call 87 percent of the time.

Without an additional ambulance, the number will continue to fall, Stark predicted.

The fire department was given funds in 2006 to purchase an ambulance to create a 10th Emergency Care Unit, but the city did not have the budget to staff it. The new ambulance was used to replace an older unit.

But Gribbin said the fire department still has older ambulances that could be put into regular rotation if personnel can be found to staff it.

Vice Mayor Linda Gorton, who attended the meeting but is not on the Public Safety Committee, agreed to set up a task force to study several issues facing emergency services personnel, including paramedic staffing, response time and the need to hire more minority and female members.